超声背向散射技术对高血压左心室胶原网络重构的评价  

Assessment of collagen network remodeling by integrated backscatter in patients with essential hypertension

作　　者：卜培莉[1] 张运[1] 钟明[1] 公茂磊[1] 侯晓阳[1] 王淑贞[2] 曹春林 

机构地区：[1]山东大学齐鲁医院心内科,济南250012 [2]山东大学齐鲁医院同位素室,济南250012 [3]山东省煤矿总医院心内科

出　　处：《中华超声影像学杂志》2005年第12期885-888,共4页Chinese Journal of Ultrasonography

基　　金：山东省卫生厅科学研究基金资助(2001CA1CJA8)

摘　　要：目的研究高血压患者胶原代谢血清指标及超声背向散射积分(IBS)的变化,探讨无创评价心肌胶原网络重构的方法及可靠性。方法按WHO/ISH(1999年)原发性高血压诊断标准选择原发性高血压患者94例,正常对照组32例。根据超声左室质量指数将高血压患者分为左室肥厚组41例、左室非肥厚组53例。应用彩色多普勒心脏超声仪测定室间隔和左室后壁图像平均声学强度及心腔标化值(AII、CAI)、峰-峰强度(PPI)等IBS参数;采用放射免疫法测定Ⅰ型前胶原羧基端肽(PICP)、Ⅲ型前胶原(PCⅢ)、透明质酸、层黏连蛋白(LN)血清浓度,并进行相关性分析。结果与对照组相比,左室非肥厚组和肥厚组AII、CAI升高,PPI降低,PICP、PCⅢ、LN浓度增加;左室肥厚组与非肥厚组相比,CAI、PICP、PCⅢ亦升高(P<0.05)。AII、CAI与PICP、PCⅢ、LN呈正相关关系。结论高血压患者血清胶原浓度增加,超声显示左室心肌胶原网络发生了重构,IBS参数是反映心肌胶原网络重构形态学特性较好的无创指标。Objective To evaluate relations between the serum marker of collagen and echocardiographic integrated backscatter（IBS） in the patients with essential hypertension（EH）. Methods According the diagnosis of EH by WHO/ISH（1999）, 94 EH patients were enrolled,41 patients with left ventricular hypertrophy（LVH） as EH-LVH group and 53 patients with none-left ventricular hypertrophy （NLVH） as EH-NLVH group, and 32 normotensive control subjects served as control group. The serum of carboxyterminal propeptide of type Ⅰ procollagen （PICP）, procollagen type Ⅲ （PCⅢ）, laminin （LN） and hyaluronic acid （HA） were measured by specific radioimmunoassay. Average image intensity of interventricular septum（AⅡ1 ） and left ventrical posterior wall（AⅡ2 ） in the parasternal long-axis view and peak to peak intensity（PPI） were measured by echocardiography. Corrected acoustic intensity （CAI） were corrected by AⅡ of ventricular chamber. Results AII,CAI of EH-LVH group and EH-NLVH group were higher than those in control group, PPI was lower （P 〈 0.05）. PICP, PCⅢ , and LN in EH-LVH group and EH-NLVH group were higher than those in control group（ P 〈0.05）, while these were higher in EH- LVH group than those in EH-NLVH group（ P 〈0.05）. AⅡ and CAI were correlated positively with PICP,PCⅢ ,and LN. Conclusions Left ventricular collagen network remodeling occurs in the patients with essential hypertension, especially in the patients with left ventricular hypertrophy. IBS is a useful noninvasive method in evaluating the degree of myocardial collagen network remodling.

关 键 词：超声心动描记术 高血压 心室功能 左 胶原 背向散射积分 

分 类 号：R445.1[医药卫生—影像医学与核医学]